Methods of prognosis and diagnosis of ovarian cancer

1. A prognostic method for predicting relapse of an ovarian cancer patient and treating the patient for ovarian cancer, the method comprising:

a) obtaining a sample of ovarian tumor tissue from the patient, wherein the ovarian tumor tissue comprises a heterogeneous population of tumor cells;

b) measuring frequency of tumor cells coexpressing at least two markers selected from the group consisting of vimentin, cMyc and HE4 in the sample of the ovarian tumor tissue; and

c) comparing the frequency of the tumor cells expressing said markers in the sample of ovarian tumor tissue to respective reference value ranges for tumor cells coexpressing said at least two markers for ovarian cancer patients who do not relapse, wherein increased frequency of tumor cells positive for both vimentin and HE4, tumor cells positive for both vimentin and cMyc, tumor cells positive for both HE4 and cMyc, or tumor cells positive for all three of the markers, vimentin, HE4, and cMyc, compared to the reference value ranges of the tumor cells positive for said at least two markers for ovarian cancer patients who do not relapse indicates the patient will relapse within 1 year; and

d) treating the patient with surgery, radiation therapy, chemotherapy, targeted therapy, anti-angiogenic therapy, or immunotherapy, or any combination thereof, if the patient is predicted to relapse.

2. The method of claim 1 , wherein a frequency of the tumor cells positive for both vimentin and HE4, the tumor cells positive for both vimentin and cMyc, the tumor cells positive for both HE4 and cMyc, or the tumor cells positive for all three of the markers, vimentin, HE4, and cMyc, greater than 1% indicates increased likelihood that the ovarian cancer patient will relapse.

3. The method of claim 1 , wherein increased frequency of the tumor cells positive for vimentin that also have higher levels of expression of cMyc and HE4 compared to the reference value ranges for ovarian cancer patients who do not relapse indicates increased likelihood that the ovarian cancer patient will relapse.

4. The method of claim 1 , further comprising detecting whether the tumor cells having increased frequency of the at least two markers selected from the group consisting of vimentin, cMyc and HE4 are E-cadherin negative cells, wherein absence of the E-cadherin in the tumor cells indicates increased likelihood that the ovarian cancer patient will relapse compared to if the tumor cells are E-cadherin positive.

5. The method of claim 1 , wherein the ovarian cancer is high-grade serous ovarian cancer.

6. The method of claim 1 , wherein said measuring the frequency of the tumor cells comprises performing multi-parametric single cell analysis.

7. The method of claim 1 , wherein the markers are detected using mass cytometry, flow cytometry, immunohistochemistry, immunofluorescence, multiplexed ion beam imaging (MIBI), or other multi-parametric single cell analysis technology.

8. The method of claim 1 , wherein said measuring the frequency of the tumor cells comprises detecting said at least two markers using an antibody that specifically binds to vimentin, cMyc or HE4, or a fragment thereof containing an antigenic determinant of vimentin, cMyc or HE4.

9. The method of claim 8 , wherein the antibody is selected from the group consisting of a monoclonal antibody, a polyclonal antibody, a chimeric antibody, a recombinant fragment of an antibody, an Fab fragment, an Fab′ fragment, an F(ab′) 2 fragment, an F v , fragment, and an scF v , fragment.

10. The method of claim 8 , wherein the antibody is conjugated to a detectable label.

11. The method of claim 10 , wherein the detectable label is a stable-metal isotope or a fluorescent label.

12. The method of claim 1 , wherein the surgery comprises a unilateral oophorectomy, a bilateral oophorectomy, or a salpingo oophorectomy.

13. The method of claim 1 , wherein the patient is human.

14. The method of claim 1 , further comprising measuring numbers of the tumor cells positive for all three of the markers, vimentin, HE4, and cMyc, wherein increased numbers of the tumor cells positive for all three of the markers, vimentin, HE4, and cMyc, compared to reference value ranges for ovarian cancer patients who do not relapse indicates an increased likelihood that the ovarian cancer patient will relapse.

15. The method of claim 1 , further comprising measuring levels of HE4 and cMyc in the tumor cells positive for vimentin, wherein increased levels of HE4and cMyc in the tumor cells positive for vimentin compared to reference value ranges for ovarian cancer patients who do not relapse indicates an increased likelihood that the ovarian cancer patient will relapse.